Florida Medicaid: 2024 taxonomy rule changes
Last modified: April 17, 2024
Update: Content updated to reflect a new effective date and claim resubmission information.
Effective Feb. 15, 2024, the Florida Agency for Health Care Administration (AHCA) is changing the taxonomy rules. This includes a new Taxonomy Master List (TML) and updates to some of the National Provider Identifier (NPI) Initiative tools and resources.
Take action
Please review the updated TML to make sure your taxonomy codes are accurate and up to date.
Remember to include the following information when submitting claims:
- NPI number, as enrolled with Florida Medicaid
- Taxonomy code for your services provided in accordance with your enrolled provider type and specialty
- Address with ZIP+4 code, as enrolled with Florida Medicaid
The new TML will be used to authenticate billed taxonomy codes on claims to valid provider/specialty type. The TML works with the existing NPI Master List to ensure valid provider type/specialty type combinations.
NPI Initiative updates
This year, the NPI Initiative includes updates to:
- NPI Mapping Logic
- NPI to Medicaid ID Search Engine
- Provider Master List (PML) (NPI crosswalk-related columns removed)
- Pending Provider List (PPL) (NPI crosswalk-related columns removed)
- Taxonomy Master List (TML)
How to submit a claim correction
If claims are denied because they were submitted with NPIs and/or taxonomy not in compliance with AHCA requirements, providers can submit a claim correction. Please use the following correction guidelines and reference our Claims Follow-Up Interactive Guide for instructions on how to submit a claim correction.
| Remittance denial | Reason | How to correct |
|---|---|---|
| N255 | Billing provider taxonomy missing or invalid on claim | Submit corrected claim with correct billing provider taxonomy |
| N288 | Rendering provider taxonomy missing or invalid on claim | Submit corrected claim with correct rendering provider taxonomy |
| N258 | Billing provider ZIP+4 or street address on claim is invalid | Submit corrected claim with correct billing provider ZIP+4 and/or street address, according to the PML |
| N294 | Service facility provider ZIP+4 or street address on claim is invalid | Submit corrected claim with correct service facility provider ZIP+4 and/or street address, according to the PML |
Resources
- For the most current information, requirements and changes related to taxonomy codes and the NPI Initiative, please reference the AHCA NPI Initiative
- Taxonomy Master List (TML) Tip Sheet
- Provider Master List (PML) Tip Sheet
- NPI Initiative Frequently Asked Questions
- Florida Medicaid: Claim and AHCA data must match | UHCprovider.com
Questions? We're here to help.
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